The Prognostic Significance of Tumor Spread Through Air Space in Stage I Lung Adenocarcinoma

Overview

Journal Thorac Cancer

Specialties Oncology
Pulmonary Medicine

Date 2022 Feb 17

PMID 35174646

Authors

Liling Huang

Le Tang

Liyuan Dai

Yuankai Shi

Affiliations

Soon will be listed here.

Abstract

Aim: There are still patients of stage I lung adenocarcinoma (ADC) suffering from local or distant recurrence. Herein we conducted a meta-analysis to investigate the prognostic value of tumor spread through air space (STAS), a new form of invasion pattern, in patients with pathologically confirmed stage I lung ADC.

Methods: Related literature was searched using PubMed, Embase, Cochrane Library, and Web of Science databases from the inception dates to September 4, 2021. Recurrence-free survival (RFS) and overall survival (OS) were set as primary outcome endpoints. In addition, subgroup analyses on operation mode, edition of the American Joint Committee on Cancer TNM staging, sample size, and research regions were also investigated.

Results: A total of 17 studies involving 9785 patients were included. The presence of STAS was detected in 31.2% of patients and was associated with poor RFS (adjusted hazard ratio [HR] = 1.93, p < 0.001) and OS (HR = 2.02, p < 0.001). In subgroup analysis on operation mode, the prognostic value of STAS was prominently shown in patients who underwent limited resection (RFS: HR = 3.58, p < 0.001; OS: HR = 3.37, p < 0.001), while for patients who underwent lobectomy, adverse impact of STAS on RFS was observed (HR = 1.60, p = 0.019), but no significant difference was observed on OS (HR = 1.56, p = 0.061). The results fluctuated in different regions while other factors did not alter the independent predictive value of STAS.

Conclusion: Tumor STAS should be considered as an adverse prognostic indicator for patients with stage I lung ADC, especially for those under limited resection. More intensive medical care for those patients needs to be investigated in further studies.

Citing Articles

[Advances in the Application of Adjuvant Chemotherapy and Targeted Therapy  in Postoperative Patients with Stage I Lung Adenocarcinoma].

Zhao K, Guo C, Chen Y, Li S Zhongguo Fei Ai Za Zhi. 2024; 27(10):777-784.

PMID: 39631834 PMC: 11629094. DOI: 10.3779/j.issn.1009-3419.2024.101.26.

Improving prediction accuracy of spread through air spaces in clinical-stage T1N0 lung adenocarcinoma using computed tomography imaging models.

Dou S, Li Z, Qiu Z, Zhang J, Chen Y, You S JTCVS Open. 2024; 21:290-303.

PMID: 39534334 PMC: 11551290. DOI: 10.1016/j.xjon.2024.07.018.

Preoperative nomogram for predicting spread through air spaces in clinical-stage IA non-small cell lung cancer using F-fluorodeoxyglucose positron emission tomography/computed tomography.

Wang Y, Lyu D, Cheng C, Zhou T, Tu W, Xiao Y J Cancer Res Clin Oncol. 2024; 150(4):185.

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An individualized nomogram for predicting and validating spread through air space (STAS) in surgically resected lung adenocarcinoma: a single center retrospective analysis.

Wang J, Yao Y, Tang D, Gao W J Cardiothorac Surg. 2023; 18(1):337.

PMID: 37990253 PMC: 10664312. DOI: 10.1186/s13019-023-02458-0.

[Analysis of Clinicopathological Features on Spread Through Air Spaces of Lung Adenocarcinoma].

Fan L, Qin J, Lin X, Wu Y, He Z, He P Zhongguo Fei Ai Za Zhi. 2023; 26(9):650-658.

PMID: 37985151 PMC: 10600750. DOI: 10.3779/j.issn.1009-3419.2023.106.18.

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